Feasibility And Responsiveness Of Isokinetic Quadriceps Function In Patients With Chronic Obstructive Pulmonary Disease

Abstract

Peripheral muscle dysfunction has been associated with impaired health status and increased mortality in patients with chronic obstructive pulmonary disease (COPD). This highlights the importance of assessing and targeting peripheral muscle strength and endurance during pulmonary rehabilitation (PR). However, information regarding the feasibility and responsiveness of isokinetic quadriceps function following PR is limited. PURPOSE: To evaluate whether and to what extent the isokinetic evaluation of quadriceps muscle function meets the pre-defined test criteria in COPD patients; to determine the response to PR of isokinetic quadriceps muscle function. METHODS: A retrospective analysis of 2033 COPD patients (age: 65±9 years, 52% male, forced expiratory volume in 1st second: 49±22% predicted) following PR was performed. Individualized exercise training consisted of endurance, interval and strength straining and/or neuromuscular electrical stimulation. Isokinetic quadriceps function assessment consisted of 30 maximal extension-flexion contractions with a full range of motion at a fixed angular speed of 90°/s (computerized dynamometer). Criteria for a correct test performance were: completion of all 30 repetitions, peak torque reached within first five repetitions, and presence of work fatigue. Differences between pre and post PR were tested using paired t-tests. RESULTS: Pre PR, 27% of the patients did not fulfil one or more of the predefined test-criteria. In patients with a correct pre and post PR isokinetic test (n=989), isokinetic quadriceps peak torque (∆=8±12Nm) and total work (∆=229±234J) were responsive to PR (both p-values<0.001). There was no change in work fatigue index following PR. CONCLUSION: Based on the current test criteria, three in four patients with COPD performed the isokinetic quadriceps test correctly during a baseline PR assessment. PR has a beneficial effect on isokinetic quadriceps peak torque and total work, but not work fatigue index, in patients with COPD. The Self Natural Posture Exercise (SNPE), created in Korea, helps to improve chronic musculoskeletal pain and joint function. PURPOSE: This study aimed to verify the effect of SNPE on knee joint function, pain, and muscle tone in women in their 20s-40s with chronic knee joint pain. METHODS: Thirty one women (34.4±6.9 yrs, 161.2±4.7 cm, 55.8±8.6 kg, 21.5±3.0 kg/m²) with chronic knee joint pain for more than 3 months were divided into two groups; exercise (EG: n=19) and control (CG: n=12). EG underwent SNPE Lower Limb Conditioning Program 80 min per session, more than twice in a week, for 12 weeks. CG did not participate in any exercise programs. For EG, before and after the program, their knee joint function (Western Ontario and McMaster University Osteoarthritis Index: WOMAC), pain (Pressure pain threshold: PPT), and